You are currently browsing the monthly archive for November 2009.

I’m going to tell you about a low point in my life. The truth shall set us free, right?

One day, I saw a friend’s status update on gmail. It said something to the affect of, “Oh, lord, I have cankles. Why??” I’d heard the term cankles before, but I wasn’t really sure what it meant. So, I went to the most scholarly, reliable source of information that I could think of: Urban dictionary. There are many definitions for cankles, and they’re linked here. But, BEWARE: reading them could cause both obsession and binding rage. At least, that’s what it did for me.

The definitions for cankles are overwhelming fat-phobic and sexist. They objectify and devalue women’s bodies, and many of the definitions specifically mention obesity,”fat chicks,” or fat bitches.” Charming, I know. I was outraged when I read these. (I have yet to check out the entry on “cankle dyke” because I think my head will probably explode.)

Yet, for all my outrage and my ability to deconstruct the misogynist bullshit in these definitions, I was suddenly VERY aware of my ankles. The obsession set in quickly. I googled pictures of cankles, trying to discern if mine qualified. I found this charming “Say No To Cankles” ad from Gold’s Gym. Later that night, unable to restrain myself, I asked my partner if I had cankles. He was not aware of cankles as a concept, so I made him google pictures of cankles with me for about 20 minutes before he finally said, “You don’t have cankles” and left the room.

I still don’t know if I have cankles. And yes, that is my leg in the picture above. I’m not asking for validation here, or fishing for you all to say, “Oh no! You don’t have cankles!” My partner said it. It didn’t help. But, it’s not really about whether we actually have them now, is it?

Here’s what’s ridiculous (okay, it’s one of many ridiculous things): I LOVE to bike. I love it. This summer, when my cankles obsession set in, I was cycling a minimum of 50 miles a week. I have had to give up cycling for the time being because my weight is too low right now to sustain it. However, I still do a lot of walking. My legs are *strong*. And yet, I am worried about CANKLES. My weight is too low, and I’m worried that my ankles might be too fat. Or my calves might not be toned enough. REALLY?? All of the women in my family carry their weight (I hate that phrase) in their legs, so I have always been obsessed with them. But I was never obsessed with my ankles until everyone started talking about cankles.

So, yes, the media DOES play a role in eating disorders and body image obsession – at least for me, and I suspect that it’s the case for many others. This is different than saying it’s THE cause of eating disorders. Perhaps it a cause. Perhaps it’s just something that perpetuates them. But, I think we need to really look at the fact that eating disorders MUST be about a lot more than brain chemistry. Again, I don’t know that we can separate the two. I don’t know that we can say biology loads the gun, environment pulls the trigger. Maybe it’s the other way around. Maybe environment is primary. Maybe it’s not. Maybe environment an biology and experience and family are all so intertwined that we just can’t separate them, can’t give primacy to any one of these factors.

It’s not a coincidence that in a time of rising media influence, the vast majority of e.d. sufferers are women.It’s not a coincidence that as unrealistic body ideals get stronger in regard to men’s bodies, the rates of eating disorders are rising in men too. Rates are also rising in areas of the world that have recently been inundated with “Western” media. Though obsession with women’s bodies and thinness is certainly not new, the ability to spread such obsession-inducing terms and campaigns so far and so easily is new. There may be a strong biological component for eating disorders, but we have GOT to examine the world around us, the structures of inequality, the forces of capitalism (want a great way to make money? break down bodies and make people obsess over each tiny part and what they can do to improve them), the role of the media, etc., and I think we are being irresponsible if we don’t. Biology doesn’t exist in a vacuum. Eating disorders don’t exist primarily in women just by chance. Cankles aren’t overwhelmingly gender-specific just because Gold’s Gym felt like making it that way for no particular reason. Yet, the media doesn’t cause eating disorders in everybody, which shows that biology, experience, etc. are obviously also important. We need to keep a holistic, intersectional view here. We can’t disentangle these things – they affect each other, and that necessarily demands that treatment be multi-faceted.

As for me? I’m done. I will not let the media have this part of my body too. My ankles are mine! I’m saying yes to my ankles, cankles, whatever! My ankles are strong. They carry me to and from school each day. They carry me around the biggest university in the country. When the rest of my body is ready, they will help me get back on my bike, where I feel free. I have put my ankles, my body, through so much, and it has not given up on me. I am my body. I am my ankles, and no one gets to degrade them. Who’s with me??

 

 

For more spot-on cankles critique, check out Julie Parker’s blog, Beautiful You.

Also, I’m still interested in all of the topics I mentioned in my previous post – I just couldn’t let this go by! But I’d still love to here what you a would like to hear about!

Advertisements

I feel so absent! I have so much that I want to write about, but alas, midterms hit last week. For me, that meant my own midterms as well as grading student papers! It’s been a bit daunting. But, I think I’m in the clear – at least for another week or so.

I’m off to a conference later today – The National Women’s Studies Association – in Atlanta. wOOt! Come on, weather in the 70s! 🙂 Hopefully it also means I’ll have some downtime to blog. Some things I’m thinking about – ideas sparked from other blogs (Surfacing after Silence and When Ed Moved In) as well as some things that have come up in support group, with friends, etc – are:

– The role of humor in e.d. treatment and recovery.

– Eating disorders as a “choice”

– Eating disorders, eating disorder recovery, and identity.

– Importance of liking, and feeling liked by, treatment providers.

I’m also WAAAAY behind on reading blogs, so I suspect I’ll be thinking about more as I catch up. And I still need to reply to a couple of comments on my last post! If any of these topics pique your interest, or if you have any thoughts about them, please let me know!

Well, actually I’m not. I’d like to, but I don’t have a horse. Also, I don’t really know how to ride. I’ve only done it a handful of times, and I’m *still* amazed that I didn’t bounce right out of the seat when I hit a canter.

I want to address this article about eating disorders and equine assisted psychotherapy (EAP) that is circulating the internet at an impressively fast rate!

First, let me locate myself so that you know where I’m coming from. I have not participated in EAP. Do I think it would be beneficial for me? Absolutely. Do I think I can recover without it? Of course. Though EAP might be helpful for me personally, I know I can recover without it because I recognize that EAP is one tool among many for treating people with eating disorders, and not a primary treatment. Though I’ve never worked with animals as a client, I am very interested in the use of therapy animals to promote healing. There’s a very good chance that I will incorporate animals into my own clinical practice someday.

What shocks me about this article is not it’s skepticism – many people are skeptical of EAP, and I think that’s largely because it’s true that not a whole lot of research has been done on it. However, not a whole lot of research has been done on the use of DBT with people with eating disorders,* and yet the author of the article is willing to jump on board with that (he even considers it an empirically-supported treatment, even as he recognizes that the empirical evidence has serious holes). No, what shocks me is that people are backing this article even though the author has a very clear, very strong bias. I know that science isn’t bias-free. I absolutely think our cultural and individual values will influence what we find and what we look for.

But, really, in this article, in the *third* sentence, he describes the reaction of him and his wife as “appalled.” Okay, he’s not a fan. I get it. But, seriously, if this article were on DBT and the author made such a strong, negative pre-judgement about the use of that therapy, I’d hope that people would be as skeptical of the author’s biased viewpoint as they are of the therapy. Or at least, I hope they’d take it with a salt lick.

He makes the point that EAP is said to be helpful for a wide-range of mental illnesses. Perhaps this is presumptuous. Perhaps it is not. It’s hard to say without the research. But, CBT has been shown to be effective for a whole host of mental illnesses, and yet that’s not questioned in the same way. And yes, we have research to support CBT. But CBT did not magically become effective when the research said it was. It was ALREADY effective, just like EAP might be. Maybe EAP is effective for some disorders, maybe not for others. Maybe it’s effective for some clients, but not for others. But what is the harm in having more therapeutic tools and experiences at our disposal? And have we considered that perhaps there’s not a whole lot of research on EAP because it’s so often stigmatized, or delegitimized before its researched? (This is not the first article I’ve seen like this recently.)

The thing is, EAP, like DBT actually, is not meant to be a “first-line” therapy in the treatment of eating disorders. It is meant to supplement other modes of treatment. And yes, there is not a lot of evidence for that. And, at the same time, it doesn’t take a whole lot of expertise to look around and see that for some, working with or being in the presence of animals helps them to open up in ways that they might generally feel unsafe doing. Obviously this is not true of everyone, and just like every treatment method used for eating disorders, EAP should not be used for everyone. It’s not a panacea. Nor is DBT. Nor is CBT. Nor is re-feeding. Nor is FBT. Nor is psychotherapy. Nor is nutritional counseling. If there is one thing we know about eating disorder treatment, it is that, more often than not, treatment requires multiple kinds of care and multiple therapeutic modalities to be effective.

So is the jury still out on EAP? Sure. Is it still out on DBT? Yes. Is the neuroscience that many of us are rallying behind still quite new? Yes. But one of these things is not like the other. Why the premature writing off of EAP? Sure, there needs to be more research done. Absolutely. But what if we left the possibility open of having another way to heal people, rather than having such a strong (and premature) bias against it? Frankly, the fact that the research is yet to be done also means that we haven’t proven that it doesn’t work. It could be incredibly effective for treating eating disorders, and we wouldn’t know that yet either.

Every treatment had a time when it lacked evidence. Every one. That’s the nature of research. So, personally, I’m going to support the use of EAP for clients who feel it would be helpful. If you ask me, the more treatment methods there are, the better equipped we’ll be to meet the individual needs of clients who are fighting this devastating illness!

* I have nothing against the use of DBT in e.d. treatment. I’m actually a proponent of it, and I personally have benefited immensely from having DBT be part of my current treatment. That said, there really is very little evidence to prove it’s efficacy for e.d. treatment yet. The small amount of literature that is there is focused mostly on bulimia nervosa and binge eating disorder. But someone has to be the pioneer if a treatment will ever gain empirical support!